Provider Demographics
NPI:1588388078
Name:SANDRA LUZ OCHOA GARCIA
Entity type:Organization
Organization Name:SANDRA LUZ OCHOA GARCIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LUZ
Authorized Official - Last Name:OCHOA GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-364-9072
Mailing Address - Street 1:1107 S 5TH AVE # 103
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-3839
Mailing Address - Country:US
Mailing Address - Phone:602-364-9072
Mailing Address - Fax:
Practice Address - Street 1:CALZADA SARATOGA #53
Practice Address - Street 2:LOS ALGODONES
Practice Address - City:MEXICALI
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:21970
Practice Address - Country:MX
Practice Address - Phone:602-364-9072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty